Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Apr 2010
Comparative StudyFeasibility of measuring myocardial performance index of the right ventricle in anesthetized patients.
Myocardial performance index, the sum of the 2 isovolumic times divided by the ejection time, contains information on global systolic and diastolic function. This study was performed to determine the feasibility of right ventricular myocardial performance index measurements if measured by transesophageal echocardiography in patients under general anesthesia and positive-pressure ventilation. ⋯ This finding questions the use of right ventricular myocardial performance index measurements in anesthetized patients under positive-pressure ventilation.
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J. Cardiothorac. Vasc. Anesth. · Apr 2010
Comparative StudyLongitudinal assessment of neurocognitive function in rats after cardiopulmonary bypass: evidence for long-term deficits.
Neurologic and neurocognitive dysfunction after cardiopulmonary bypass (CPB) have been shown in both clinical and experimental settings. Although short-term outcome has been evaluated in rats, the assessment of neurocognitive dysfunction with long-term follow-up has not been reported in experimental CPB models. The objective of this study was to evaluate the effects of CPB on long-term neurocognitive function in the rat. ⋯ Compared with sham-operated controls, rats undergoing CPB showed worse neurologic and neurocognitive outcome early after surgery. Importantly, long-term deficits also persisted at 6 weeks after surgery.
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J. Cardiothorac. Vasc. Anesth. · Apr 2010
Comparative StudyUncalibrated radial and femoral arterial pressure waveform analysis for continuous cardiac output measurement: an evaluation in cardiac surgery patients.
Arterial pressure waveform analysis is a less invasive alternative to the pulmonary artery catheter for continuous cardiac output (CO) measurement. Uncalibrated and calibrated systems are actually available (ie, the FloTrac/Vigileo system [Edwards Lifesciences, Irvine, CA] and the PiCCOplus system [Pulsion Medical Systems, Munich, Germany]). According to the FloTrac/Vigileo manufacturer, reliable measurements can be performed using any existing arterial catheter. The aim of this study was to evaluate CO determined by the FloTrac/Vigileo system using a radial (FCO(radial)) and femoral arterial catheter (FCO(femoral)) as well as the PiCCOplus system (PCO). Intermittent pulmonary artery thermodilution (ICO) was used as primary reference technique. ⋯ Performance of the FloTrac/Vigileo system via radial as well as femoral access and the PiCCOplus monitoring for cardiac output measurement were comparable when tested against intermittent thermodilution in cardiac surgery patients.
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J. Cardiothorac. Vasc. Anesth. · Apr 2010
ReviewClinical update in cardiac imaging including echocardiography.
Volumetric determinations by cardiac magnetic resonance imaging after tetralogy of Fallot repair may more accurately assess significant right ventricular dilation and pulmonary regurgitation to guide timing of pulmonary valve replacement. Recent guidelines by the American and European Societies of Echocardiography have summarized the clinical approach to valvular stenosis. They emphasize aortic stenosis given its high incidence and assessment confounders such as left ventricular function, aortic regurgitation, systemic hypertension, and mitral regurgitation. ⋯ At the time of mitral surgery, moderate or greater tricuspid regurgitation should be corrected, preferably by rigid annuloplasty. Recent evidence also supports tricuspid annuloplasty for an annular diameter >35 mm regardless of regurgitation severity. Although repair is preferred, tricuspid replacement also has acceptable outcomes.